Overview of Bariatric Operations

Overweight, obesity, and morbid obesity, defined as body mass indices greater than or equal to 25, 30, and 40 kg/m2, respectively, constitute a burgeoning global epidemic. Approximately 30% of Americans are obese, of whom over 5 million suffer from morbid obesity. For the latter cohort, bariatric surgery is the only effective means to achieve significant weight loss with improvement or resolution of comorbid diseases. The field of bariatric surgery began over 50 years ago and has grown steadily and, over the last decade, explosively, with over 100,000 procedures performed annually in the United States.

The purpose of this chapter is to present the reader with a framework for understanding the numerous described bariatric surgical procedures along with their historical development. The evolution of these operations has not been a linear process, as previously abandoned procedures have been modified and reintroduced. As newer technologies emerge, this framework will permit the reader to compare their function, advantages, and limits of use to existing procedures.

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